Abstract
Abstract Objectives: to describe the trend of preventable neonatal mortality due to interventions by the Unified Health System in Brazil from 2000 to 2018, according to groups of causes of death and maternal residence. Methods: mixed ecological study with data from the Mortality Information System and Information System on Live Births. The analysis occurred based on the number and rates of avoidable neonatal mortality, polynomial regression models by least squares method and thematic maps. Results: the avoidable neonatal mortality rate decreased from 10.98 in 2000 to 6.76 per 1,000 live births in 2018. Preventable causes prevailed due to adequate care for women during pregnancy, childbirth, fetus and newborn. Deaths from preventable causes from health promotion actions during pregnancy increased in Maranhão (p=0.003) and the Federal District (p=0.001) and remained stable in nine states. There was stability in the rates of mortality due to delivery in Maranhão, Piauí and Amazonas. The causes avoidable by actions with the newborn showed a decreasing trend, except for Roraima where there was stability. Conclusions: there are inequalities in trends of avoidable neonatal mortality rates in the states second according to the group of causes and the need to improve access to and quality of maternal and child health care in these places
Highlights
It is the main component of infant mortality, neonatal deaths worldwide reduced from 37 deaths per 1,000 live births in 2000 to 18.0 per 1,000 live births in 2017.3 In Brazil, the neonatal mortality rate, which was 26 deaths per 1,000 live births in 1990, declined to 16.7 per 1,000 live births in 2015.5 The implementation of public policies aimed at improving maternal and child health care contributed to this decline in Brazil, including the National Program for the Humanization of Childbirth and Birth in 2000 and the Stork Network in 2011, aiming to achieve the goals established in the Millennium Development Goals (MDGs), defined by the United Nations (UN).[6]
The classification occurred by comparing the International Code of Diseases (ICD) of the basic cause of death field (CAUSABAS), with the codes contained in the "List of causes of preventable deaths by interventions of the Brazilian Unified Health System"
From 2000 to 2018, 56,442,235 records were identified in SINASC and 591,097 records of neonatal deaths in SIM, 76% of which were classified as preventable by interventions by the Unified Health System
Summary
Neonatal death is that which occurs from zero to 27 days of life and is considered an important indicator of public health in countries,[1,2] with causes related to healthcare offered during pregnancy, childbirth and after birth.[3,4] it is the main component of infant mortality, neonatal deaths worldwide reduced from 37 deaths per 1,000 live births in 2000 to 18.0 per 1,000 live births in 2017.3 In Brazil, the neonatal mortality rate, which was 26 deaths per 1,000 live births in 1990, declined to 16.7 per 1,000 live births in 2015.5 The implementation of public policies aimed at improving maternal and child health care contributed to this decline in Brazil, including the National Program for the Humanization of Childbirth and Birth in 2000 and the Stork Network in 2011, aiming to achieve the goals established in the Millennium Development Goals (MDGs), defined by the United Nations (UN).[6]The main risk factors for neonatal death are the absence or low quality of prenatal care, maternal health complications during pregnancy, low birth weight, asphyxia at birth and prematurity,[7] which are injuries considered preventable by health service interventions.[8]. Neonatal death is that which occurs from zero to 27 days of life and is considered an important indicator of public health in countries,[1,2] with causes related to healthcare offered during pregnancy, childbirth and after birth.[3,4] It is the main component of infant mortality, neonatal deaths worldwide reduced from 37 deaths per 1,000 live births in 2000 to 18.0 per 1,000 live births in 2017.3 In Brazil, the neonatal mortality rate, which was 26 deaths per 1,000 live births in 1990, declined to 16.7 per 1,000 live births in 2015.5 The implementation of public policies aimed at improving maternal and child health care contributed to this decline in Brazil, including the National Program for the Humanization of Childbirth and Birth in 2000 and the Stork Network in 2011, aiming to achieve the goals established in the Millennium Development Goals (MDGs), defined by the United Nations (UN).[6]. The identification of the trend of avoidable neonatal mortality in different spaces and realities can optimize care practices, contribute to the rational use of resources and reorganize care networks to promote the reduction of health inequities.[12]
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